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johnson bayou, la: after I eat a meal that includes bread, rice like pizza i get real light headed dizzy and just want to go to sleep. i do have frequent urination and fatigue quiet often. any suggestions as to what i may do to find out what my problem is?

Lorena and Margie: Some of the symptoms such as frequent urination and fatigue could be symptoms of diabetes or high blood sugars however it is difficult for us to determine why those symptoms are occuring. We suggest seeing your physician to evaluate your condition.

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ADA Moderator : Welcome to ADA Live!

Today our guests are Lorena Brandl, R.Ph., Pharm D. a drug information specialist at the Rite Aid Drug Information Center and Margie E. Snyder, PharmD is a Community Practice Resident with the University of Pittsburgh and Rite Aid Corporation.

It's a pleasure to have you here today Lorena and Margie.

Lorena and Margie: Thanks. There are a lot of great questions today.

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regina sask: what are the health risk's of diabetes ?

Lorena and Margie: Diabetes that goes untreated leads to heart disease, blindness, kidney disease, nerve damage, and a greater risk of amputations. It is very important to keep blood sugars within goal range. People with diabetes can live long, healthy, happy lives. The important thing is to take care of yourself and follow your physicians recommendations.

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Independence, Kentucky, 41051: I understand hot tubs should not be used by diabetics. I am type 2, controlled with diet and exercise. I use my hot tub keeping the water temperature at 98. State legal limit is 104 degrees. Do you recommend I do get in the hot tub and soak.

Lorena and Margie: You would need to speak with your physician before soaking in the hot tub. As diabetes can impact the ability to feel heat, an individual with diabetes can be at an increased risk for severe burns. You should discuss your diabetes control and desire to use the hot tub with your doctor before making the decision.

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MESA,AZ: HOW MANY PEOPLE DIE BECAUSE OF DIABETES?

Lorena and Margie: Uncontrolled diabetes can lead to long term complications which cause mortality or death. Patients with diabetes have an increased prevalence of lipid or cholesterol abnormalities which increases the risk of heart attack and stroke. In addition patients with diabetes can suffer from insufficient blood circulation and cause complications such as damage to the eyes, kidneys and limbs. This is why it is important for patients with diabetes to achieve and maintain blood glucose control by using drug therapy and lifestyle management.

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Indian River, Michigan: Monday my mom woke up and could not feel her entire right side of her body my dad was frustrated because she wouldn't respond and she said she wanted to talk to him but couldn't move her lips. Is this a stroke? My father and sister insist that it happens all the time and that we do not need to contact the doctors. What would be the best way to make them understand the seriousness my mothers health?

Lorena and Margie: We can not diagnose your mother's condition. We suggest speaking to her physician for an evaluation of her condition.

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hillsboro, texas: My mother recently had a blood test and her blood sugar was a little high. Her doctor recommended that she have another test where she fasts before the test. How long does she need to fast prior to the test?

Lorena and Margie: Fasting blood sugar readings are based on an 8 hour fast (nothing to eat or drink except for plain water.)

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lemoore ca: My husband was very recently diagnosed w/diabetes, however they said we have to wait two weeks to get the results back to find out which type he has(type one or two).I've changed his diet drastically,but none of the so called dr.'s have been able to give us a guideline or numbers we should be using for daily limits on his carbs and sugars.Is it based on the individual or in there a general number or limit I can use until we get in to see the dietician next week??

Lorena and Margie: Carbohydrate intake in people with diabetes is certainly individualized and it is wonderful that you will be seeing a dietician soon. For now, I would recommend maintaining a healthy, balanced diet with plenty of fruits and vegetables and fluids (like plain water.) You can make small changes (reduce portion sizes, eliminate regular soda) but the ADA does not recommend very low-carbohydrate diets (i.e. less than 130 grams of carbs per day.)

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New Kensington, PA: I am pre-diabetic and have been advised by my PCP to change my eating habits. I have been trying to limit sugary ingredients. I am curious as to the advisability of eating dried fruits. The nutrition labels indicate they are extremely high in sugars. Good or bad? All advice will be greatly appreciated. Thank you P. James pej2006@earthlink.net

Lorena and Margie: Please read the ADA website: http://www.diabetes.org/nutrition-and-recipes/healthyfoodchoices.jspand consider making an appointment with a dietician to talk over the specifics of your nutrition. It sounds like this would be a great place for you to start!

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Binghamton City, NY: if my FBS is 586 and my AIC is 11 and i have COPD and renal roblem what best medication will i take

Lorena and Margie: Your physician will determine the most appropriate medication for you with your current conditions.

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Oak Ridge, TN. : Is there a relationship to going without food for perhaps as little as 6 hours or as long as 24 or 28 hours, and as result, see a diabetics type II diabetes impact or contribute to cause a shut down of actions of stomach and/or intestines for some too long a periods?

Lorena and Margie: For people with Type 2 diabetes, going for long periods of time without food can certainly impact your blood glucose. Please consult your physician or see a dietician for further information.

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Woodbury, Minnesota : I completely forgot to take my Metformin at dinner last night at dinner - had a fitful night's sleep and when I woke up this morning my blood sugar was 256???? What should I do. I usually take my Actos after breakfast. I feel like I have been on a rocking ship all night. Not l00% right now. Also, any ideas on new in between snacks I can eat. Getting BORED with what I'm doing now. Thank you for your kind assistance.

Lorena and Margie: When you forget a medication dose, it is important to never "double up" or change your regular medication dosing schedule without speaking to your physician. Continue to test your sugar, drink plenty of fluids, and consider testing for ketones. Call your physician if your blood sugar remains elevated. At your next visit, you may want to discuss this plan for high sugars in depth so that you can feel comfortable with what you need to do and how best to contact your doctor if necessary. You may visit the American Diabetes Association's website at this link to find new and different snack combinations: http://vgs.diabetes.org/recipe/recipeCategory.jsp?CategoryID=6

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Marrero, La.: My husband is 36 and has just been diagnosed with Diabetes. I am not sure how to determine if it's type 1 or 2. For now he has been prescribed Actoplus Met 15mg/850mg one tablet each morning. Thanks Claudia M.

Lorena and Margie: Insulin is a hormone produced by the pancreas and is necessary for survival. People with Type 1 do not have any insulin production, therefore must supply their bodies with insulin from an outside source. People with Type 2 diabetes have some insulin production, but either have problems with the body utilizing it or with the pancreas not releasing the insulin properly. Medication is prescribed based on your body's needs. Medication for type 2 diabetes either helps to increase insulin in the body, or increases your body's sensitivity to the insulin it supplies, or both. The medication you named contains two different types of medication used to treat Type 2 diabetes (metformin and pioglitazone) which helps the body utilize insulin more efficiently. You and your husband may speak with his doctor about diabetes and you may wish to ask about seeing a Diabetes Educator for further information.

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Tacoma, WA: I'm 10 weeks pregnant and feel very weak and shaky. A couple weeks ago I had by blood sugar checked and it was 129. I haven't been treated for diabetes, but I just don't know why I feel this way. My legs sometimes feel like jell-o and I start sweating. What's wrong?

Lorena and Margie: Gestational diabetes occurs when a pregnant woman who has never had diabetes before has high blood sugar (glucose) levels during pregnancy. Gestational diabetes affects about 4% of all pregnant women. The ADA (American Diabetes Association) recommends that all pregnant women be screened between 24 and 28 weeks of pregnancy. This is done by taking a glucose challenge test (GCT) in which you drink 50-g of glucose and then your glucose level is taken 1 hour later. If the value is equal to or above 140mg/dL then an oral glucose tolerance test (OGTT) is done. For the OGTT, you would fast and then receive 100-g of glucose after a fasting glucose level is obtained. Then a blood sample is taken every hour for 3 hours. The opposite condition of hyperglycemia or high blood glucose levels would be hypoglycemia or low blood sugar levels. Symptoms of hypoglycemia include shakiness, dizziness, inability to concentrate, headache, sweating, hunger, fast or pounding heart, fatigue, paleness, weakness, fainting, sudden moodiness or behavior changes, tingling sensations around the mouth, clumsy or jerky movements, and poor or blurred vision. We suggest you contact your physician for an evaluation of your symptoms.

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Phoenix Arizona: Where do I take used insulin syringes for disposal

Lorena and Margie: Please follow this link to the ADA website: http://www.diabetes.org/for-parents-and-kids/diabetes-care/sharps.jsp . This site provides great guidance on this subject.

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Lenoir, North Carolina: I am diagnosed with type 2 diabetes and my doctor has given me a prescription for Lantus. 10 units once a day. My question: After I begin taking the injections is there any real harm in having a few coctails in the evening? My drink of choice is Gin Martini or Gin and Tonic. I occasionally drink red wine with evening meal.

Lorena and Margie: Please see the following section on the ADA website about alcohol use. It is a great resource. http://www.diabetes.org/type-1-diabetes/alcohol.jsp. Please speak with your physician for more information and to discuss the specifics of your treatment and alcohol use.

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hackensack ,nj: I have a client that says he's on Januvia?? A diabetic medication. do you have any info on it?

Lorena and Margie:

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Clewiston, Florida: Is diabetes curable?

Lorena and Margie: There is currently no cure for diabetes. However, with proper diet, exercise, and/or medication, diabetes can be kept "under control". For more information on diabetes, you may want to visit the American Diabetes Association on the internet at http://www.diabetes.org or Rite Aid's diabetes webpage at http://www.riteaiddiabetes.com.

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Pittsburgh, PA: My doctor diagnosed me with Diabetes 2 after a blood test and he wants to put me on medications without trying exercise and diet first. He was it was 6.4 and he wants glucose to be under 6.5. Where does that fall in the guidelines for Diabetes 2? ecgorecki@aol.com

Lorena and Margie: The ADA suggests a goal A1C of <7% and the American College of Endocrinology suggests a goal A1C of <6.5%. However, the ADA recommends an A1C of <6% (as close to normal as possible without significant low blood sugars) for certain individual patients. Please speak with your doctor to discuss your specific blood sugar goals and treatment plan.

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SACRAMENTO, CA: I experiencing itching on my legs and arms, could that be my diabetes?

Lorena and Margie: Itching may be a sign of high blood sugar. It can be caused by a yeast infection, dry skin, or poor circulation. Also, high glucose levels and frequent urination commonly cause people with diabetes to become dehydrated which can lead to dry skin. Keeping tight control of your blood sugars may improve this condition. To help decrease or prevent dry skin, limit how often you bathe, particularly when the humidity is low; use mild soap with moisturizer and apply skin cream to your body after bathing; apply lotion to the tops and bottoms of your feet do not apply them between the toes; and keep your home humid to prevent your skin from drying. Your itching may also be due to other conditions so you should consult your doctor to determine the cause and best treatment.

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clarks nebraska: my question is, how do you get diabetes? because i know that my friends just got it when they were 14.

Lorena and Margie: Both genetics (family history) and environmental factors are involved with developing diabetes. Type 1 diabetes is the result of destruction of the cells in the pancreas that make insulin. Insulin is the hormone that helps the body to utilize sugar and regulate metabolism of carbohydrates. For patients with Type 1, insulin treatment is used because it is needed to replace the insulin which the individual is not producing. In Type 2 diabetes patients develop a "resistance" to insulin meaning that more insulin is required to have the same effect. Over time, these patients also can become deficient in insulin.

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Paterson, NJ : I just got diagnosed with diabetes today I checked and I have it at 330 what could I do to bring it down. I have a healthly meal today,

Lorena and Margie: As you have recently been diagnosed, I would recommend that you speak with your doctor about seeing a Diabetes Educator. They can help you to learn more about diabetes and answer your specific questions. To find an educator in your area: Go to http://www.aadenet.org (the website for the American Association of Diabetes Educators). In the bar on the left side of the screen, click on "diabetes education" then "find a diabetes educator". There you can enter your zip code and find the closest educators. Hyperglycemia (high blood sugar) may be controlled with oral diabetic medications and/or insulin therapy. Exercise is also a common treatment for hyperglycemia. (Please note: If your blood sugar is higher than 240mg/dL, check your urine for ketones before exercising. If there are ketones in the urine, do not exercise, this could make the blood sugar even higher. Contact a doctor if this occurs.) Other measures that may be taken to help decrease your blood sugar include changing your diet and increasing water consumption. You should speak with your doctor about your specific medication regimen. Never take extra medication without consulting your doctor.

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Salem, Oregon: I am a Type I diabetic since 1975. For being diabetic for 30 years I am actually quite healthy. Recently, I have developed a purplish color across my knuckles on both hands and my hands burn at night. Could this be associated with my diabetes? Thank you

Lorena and Margie: Burning in the hands or feet could be a symptom of neuropathy. Neuropathy is one of the most common complications for people with diabetes. Neuropathy is damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. The cause of neuropathy is unknown and currently there is no cure. There are different types of neuropathy which are classified based on if they affect one or both sides of the body, the type of nerve(s) affected, the number of nerves affected, and the parts of the body affected. We recommend speaking to your physician regarding your recent symptoms for an evaluation.

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texas city texas: i have heard a dabetic cannot eat pineapple, is this true?

Lorena and Margie: You may have heard this because of the carbohydrate or natural sugar content of pineapples. Two slices (about 4 oz) of fresh pineapple contains 16 grams of carbohydrates, which needs to be accounted for in planning your meals. You can compare this to a slice of bread that has about 15 grams of carbohydrates. Pineapples are a healthy fruit that can be used in your meal plans.

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new york new york: it has been my understanding that i should test my blood sugar levels before and after meals, ideally each meal aa often as I can comply with this. my doctor says it's only necessary to do it one time per day making sure to cover all different times throughout the week. i'm not comfortable with this because i like to know what's happening. the issue here is that my insurance company will send me, free of charge, testing supplies for as many times per day as my doctor authorizes. what is the recommended number of times to test if your sugar is relatively stable (my last aic was 5.8 but i do cheat and overeat). thanks

Lorena and Margie: The recommended frequency of blood sugar testing partially depends on what medications are being used to treat diabetes. The ADA recommends that people using multiple insulin injections each day should test at least three times daily. It is less clear how often stable, diet-controlled patients should test. For patients using oral medications, your doctor's recommendation may be based on your A1C, the type of medication and how likely it is to cause low blood sugar or how often you have experienced low blood sugar in the past. I suggest that you schedule a time to discuss your concerns with your doctor so that you can be comfortable with the number of times you are testing.

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COLUMBIA, TN: What is ADA recommendation for a normal range for a glucose?

Lorena and Margie: General blood glucose level guidelines according to the American Diabetes Association (ADA) are: A1C - Less than 7%, Before meals - 90 - 130 mg/dl (5.0-7.2 mmol/l), and Peak after a meal (1-2 hours after the start of a meal) - Less than 180 mg/dl (less than 10 mmol/l). The new general blood glucose level guidelines according to the American College of Endocrinology (ACE) are stricter than the ADA guidelines and include: A1C - Less than or equal to 6.5%, Before breakfast in the morning - Less than 110 mg/dl (less than 6.1 mmol/l), and Two hours after eating a meal - Less than 140 mg/dl (less than 7.8 mmol/l). You should consult your physician to determine what specific goals are appropriate for you.

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Los Angeles ,CA: What is a serving size for noodles, kidney beans, and rice 1/3 or 1/2 cup? I was told it changed recently. Thank you

Lorena and Margie: Please refer to the following ADA site: http://www.diabetes.org/nutrition-and-recipes/nutrition/foodpyramid.jsp Per the site, "A serving of pasta or rice is 1/3 cup in the Diabetes Food Pyramid and ½ cup in the USDA pyramid."

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dubai, uae: I have been diagonised for 2 nd type diabetics i am around 48 now ,,, the glucose ranged upto 145 fasting ,,, wht food should i take now ,,i do yoga and walk at least 35 mints.. i am basically a vegetarian and dont drink or smoke

Lorena and Margie: It sounds like you are doing a lot of great things! By exercising often (as allowed by your physician) and not smoking, you are certainly helping to maintain your overall health and prevent complications associated with diabetes. A few general tips to keep in mind: Balanced nutrition is extremely important in managing blood glucose levels. Eating three meals a day plus small snacks in between and at bedtime can prevent extreme fluctuations in blood glucose. Fifteen grams of carbohydrate equals one serving. General guidelines for carbohydrate intake are 3-5 servings of carbohydrate (45-75 grams) per meal and 1-2 (15-30 grams) servings of carbohydrate per snack. The American Diabetes Association recommends that people with diabetes follow an individualized meal plan based on their lifestyle to manage diabetes and weight. If you have not already, we recommend that you speak with a registered dietician to help develop a meal plan that is appropriate for you. We also recommend that you view information from the National Diabetes Information Clearing House at the following website: http://diabetes.niddk.nih.gov/dm/pubs/eating_ez/index.htm or http://diabetes.niddk.nih.gov/treatments/index.htm You may also visit www.riteaiddiabetes.com for extensive information on meal planning and food choices.

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London, Ontario Canada: What are the symptoms for high and low blood sugar? Thanks. Geoff

Lorena and Margie: Common symptoms of diabetes (hyperglycemia or high blood sugar) include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurred vision. Symptoms of hypoglycemia (low blood sugar) include hunger, shakiness, dizziness, confusion, weakness, sweating, and rapid heart beat. If you are concerned about developing diabetes, that you have diabetes, or are having any of the symptoms of diabetes, we recommend that you speak with your doctor for an examination and appropriate testing. Additionally, you may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org.

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Belfair, Wa: I think I might have diabetes, but I don't know what kind of doctor I need to go to, to get tested. Are there specific doctors that can only test me for it, or can a general doctor test me for it as well?

Lorena and Margie: Your primary doctor can do the test for you. In order to diagnose diabetes the doctor must complete a blood test, either a fasting plasma glucose test or an oral glucose tolerance test. The results will determine if you have pre-diabetes, diabetes, or are have normal blood glucose levels. The fasting plasma glucose test measures the blood glucose level first thing in the morning after a person does not eat (fasts) overnight. The fasting plasma glucose test defines pre-diabetes as blood glucose levels between 100 and 125 mg/dl and diabetes as blood glucose levels at 126mg/dl or above. The normal fasting blood glucose level would be less than 100 mg/dl. The oral glucose tolerance test measures blood glucose levels first thing in the morning after a person fasts and then again 2 hours after the person ingests a drink that contains glucose. With this test, pre-diabetes is defined as the 2-hour blood glucose level between 140 and 199 mg/dl and diabetes as the 2-hour blood glucose level at 200mg/dl or above. The normal 2 hour blood glucose level would be less than 140 mg/dl. Common symptoms of diabetes include excessive thirst, extreme hunger, frequent urination, irritability, increased fatigue, unusual weight loss, or blurred vision. If you are concerned about developing diabetes, that you have diabetes, or are having any of the symptoms of diabetes, we recommend that you speak with your doctor for an examination and appropriate testing. Additionally, you may want to take the American Diabetes Association Diabetes Risk Test available online at http://www.diabetes.org/risk-test.jsp. For additional information on diabetes, please visit the Rite Aid Diabetes website at www.riteaiddiabetes.com or the American Diabetes Association's website at www.diabetes.org.

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Kenner, Louisiana: I am 20 years old, male, and have Type 1 diabetes. I started to eat meals with less carbohydrates and more fiber and protein, my sugar levels have been outstanding, and I cut my insulin level injections by half! The problem is that I feel weaker than when I used to eat more carbs. I want to keep my insulin level down, is there anywhere else I can get the energy I need other than in foods that contain too much carbs?

Lorena and Margie: Your body needs carbohydrates--it is just important to keep them in balance with everything else. When you do not eat enough carbohydrates, your body turns to fat for energy. Fat is not as readily available for quick energy. Carbohydrates can be stored for the body to use as a quick source of energy. In general, the ADA does not recommend restricting carbohydrates to less than 130 grams per day. Please make an appointment to see a dietician and check out the ADA website: www.diabetes.org/nutrition-and-recipes/healthyfoodchoices.jsp for additional information.

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grenada,ms: how many carbohydrates should a male person, who has diabetes have a day if their weight is about 235

Lorena and Margie: Your best source to determine a proper balance in your dietary intake would be to consult with a dietician. Ask your physician if he/she can recommend one that you can talk to. You may also call your local hospital who may have a dietician on staff who can meet with you and help you determine how many carbohydrates you should consume in a day and how to determine what is considered a carbohydrate.

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joliet,illinois: can diabetes cause you to feel like the room is spinnig really fast and vomiting

Lorena and Margie: Symptoms of hypoglycemia (low blood sugar) include dizziness, along with feeling hungry, unable to concentrate, shakiness, sweating, weakness, and fainting. However, the symptoms you describe could be due to other things. If you have diabetes, you should test your blood sugar often when you are ill and record the readings. I would recommend that you contact your doctor to discuss the symptoms you describe to determine if they are caused by your blood sugar or by something else and to obtain proper treatment.

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mumbai,india: my mom has type 1 diabeyes.she got herself chccked after 4 months and now her sugar level is 600 after food.should she get hospitalised.her dr says its not necessary.please tell me fast.

Lorena and Margie: A blood sugar reading of 600 mg/dL is serious. Short term (days to weeks) hyperglycemia (high blood sugar) can lead to increased urination, increased thirst, weight loss, blurred vision, fatigue, nausea, and can also lead to many fungal and bacterial infections. More serious complications include diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Diabetic ketoacidosis (DKA), also known as diabetic coma, occurs when the body lacks insulin and breaks down fats for energy. When this occurs the body produces ketones which can be found in the urine. Ketoacidosis occurs when the body does not get rid of all the ketones in the urine and they build up in the blood. This is a life-threatening situation and needs immediate treatment. DKA is associated with blood glucose levels from 200-2,000mg/dL. Symptoms of DKA include unexplained blood glucose greater than 250mg/dL, fruity smelling breath, dry mouth, nausea, vomiting, fever, abdominal pain, low blood pressure, shortness of breath, dehydration, increased heart rate, shock, and coma. Medical assistance is needed from hospital staff. Treatment includes insulin infusions, fluid replacement, and potassium replacement. Hyperosmolar hyperglycemic non-ketotic syndrome (HHNKS) can be life-threatening and is associated with blood glucose levels greater than 600mg/dL. Symptoms of HHNKS include dehydration, excessive thirst, low blood pressure, glucose in the urine but no ketones, hallucinations, sensory deficits, rapid eye movements, paralysis on one side of the body, loss of vision in half of the visual field, seizures, and a partial or total loss of the ability to comprehend spoken or written language and express ideas. Medical assistance is needed from hospital staff. Treatment also includes fluid replacement, potassium replacement, and insulin infusions. Contact the doctor if the blood sugar readings continue to remain high.

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new york city,n.y.: i was diagnosed w/diabetes last month. i had my 1st visit w/ my endocrinologist 2 weeks ago. we discussed the illness in deepth. i was in slight shock, but i am dealing with slowly. he told me to lose weight, cut out starches as much as i can indure. my question is should i invest in a glucose meter? if so which one should i buy or should i just have the dr. prescribe one for me and let the insurance cover the cost.

Lorena and Margie: Testing is a great way to learn about how your body responds to food, medications, illness, stress, etc. It is an important part of managing your diabetes. How often you test is dependent on many factors and you should discuss this with your doctor. Meters have a lot in common but there are differences between them that may determine which one is best for you. Some offer larger print, alternate site testing, smaller required blood samples, shorter wait time for results, etc. Meters and testing supplies are also commonly covered by insurance. You may want to speak with your doctor, pharmacist, and diabetes educator about which meter would be best for you and then have them work with you to determine insurance coverage.

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Harrison, Arkansas: What can I get my wife to monitor her glucose level that won't require pricking her finger. They are blue and sore. I underdstand there is a monitor that is similar to a wrist watch? Where can we get one and approximate cost. Or is there something better. Jim

Lorena and Margie: GlucoWatch is indicated to supplement, not replace regular glucose testing. It records the blood sugar every 10 minutes for up to 13 hours. It's readings have about a 15 minutes lag time from regular testing, which might pose a problem in the event of low blood sugars. The watch sells for about $600 and the sensors, which must be changed at least every 13 hours, run $7.50 each. A statement of medical necessity is required for insurance coverage. You can find more information at www.glucowatch.com. Additionally, most modern blood glucose meters offer alternate site testing. While still invasive, alternate site testing can give the fingers a break. Finger testing is still recommended by many educators for post meal testing, testing around exercise, and for treatment of hypoglycemia as alternate sites can have a lag time. Glucose testing from the fingers has the most up-to-date glucose information, but alternate site testing can be appropriate for before meal tests. A few other tips: many lancing devices allow you to set the depth for the needle, so a patient who obtains blood more easily can use a lower setting which should hurt less. She could also trying running her hands under warm water or rubbing them together first to make it easier to obtain blood when testing. If she is interested in the Glucowatch or alternate site testing, she should speak with her doctor or diabetes educator to determine a testing process that is best for her.

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nashua, new hampshire: what sorts of food are healthy for you to eat when you are diagnosed with diabetes?

Lorena and Margie: The ADA website has a multitude of resource material in regards to healthy eating and meal planning, please visit www.diabetes.org/nutrition-and-recipes/healthyfoodchoices.jsp. Additionally, it may benefit you to meet with a dietician. Ask your physician if he/she can recommend one for you to see.

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Moscow, Id: I really feel that I may have diabetes, or severe depression... is there a way to test at home?

Lorena and Margie: Although there is not an accurate way to test for diabetes (or depression) at home, you should definitely speak with a doctor about your concerns. If you do not have insurance or a doctor, you could speak with your local pharmacist or health department for advice regarding local doctors or clinics that do not require insurance.

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Redding, California: I am a type II diabetic. I was diagnosed approximately 1 year ago. Since then, my sugar levels have never been under 150. Recently my provider started me on injections of insulin, 10 units at bedtime and one pill in the morning of 1000 mg of glucophage. Sugars are higher now then they were before. Whats the deal?

Lorena and Margie: Many factors influence blood sugar levels and without discussing these in depth, I am not able to give you a complete answer. I recommend that you test your blood sugar as directed by your physician, record these readings, and make note of any changes in your diet or other daily activities. Please take this information and schedule an appointment with your physician to discuss your concerns.

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springfield virginia: in past year i have been caughing a lot when i was drinking soda or sugery food and or vomating it back out. Also feeling irrating a litte now. Is these the causes of diabeties?

Lorena and Margie: Although coughing/vomiting are not typically considered symptoms of diabetes, they could be associated with a number of medical conditions. Please speak with your physician to determine a diagnosis and appropriate treatment.

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bx,ny: is dm hereditary

Lorena and Margie: Family history is certainly a strong risk factor for diabetes. Other risk factors include age, having a baby weighing greater than 9 pounds at birth (or had gestational diabetes), pre diabetes (fasting blood sugar 100-125mg/dl), high cholesterol or blood pressure, obesity, inactive lifestyle (exercise fewer than 3 times per week)and certain ethnic backrounds (African American, Asian American, American Indian, Latin American, Pacific Islander, Alaska Native).

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boynton beach fl: my husband has type 2 diabetes. HE TAKES INSULIN DAILY. 12 UNITS. IF HIS SUGAR IS ABOVE 170 HE WILL TAKE THE NOVALOG PEN ON TOP OF IT AND THEN HE GETS READINGS OF 68 AND 70 AND SLEEPS AND CANNOT FUNCTION. WHAT DO I DO

Lorena and Margie: I recommend that your husband make an appointment with his physician. Hypoglycemia (low blood sugar) is when blood sugar readings are below 70 mg/dL. These readings require treatment with glucose and should be discussed with his physician as soon as possible. He may require an adjustment in his insulin dose to help prevent this from happening.

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Indio: what are the symptoms for diabetes on a child?

Lorena and Margie: Children often have no symptoms of diabetes before they are diagnosed because their blood sugar level has been rising so slowly. As a result, a child may have diabetes for several years before being diagnosed. When children do have symptoms, the most common include slight increase in the frequency of urination or slight increase in thirst. Other symptoms may include increased tiredness, nausea, blurred vision, frequent infections and slow-healing wounds or sores, and/or weight loss.

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Southwick, MA: What do you do if your glocose level is high? How do you bring the sugar level down?

Lorena and Margie: Eating the right foods, increasing water consumption and exercising (if approved by your physician) will help lower your blood sugar in addition to oral medications and insulin. If altering your diet and exercise do not work, you may need to have the doctor adjust your medication or insulin. If your blood sugar is higher than normal, you should not give yourself additional medication or insulin other than what was prescribed by your physician unless otherwise directed to do so. The ADA recommends fasting blood glucose (before meals) 90-130mg/dl, postprandial glucose (peak after a meal) below 180mg/dl, and A1C less than 7.0%. We can not determine the best medication regimen for you. Please consult your physician regarding your concerns.

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Hoover, AL: What is the blood sugar fasting range for a person with Type 2 diabetes upon rising in the am after 5-7 hours without food?

Lorena and Margie: Fasting is defined as no calorie intake (i.e. nothing but plain water) for at least 8 hours and the ADA goals are based on this definition. The ADA blood sugar fasting goal is 90-130 mg/dL. If you have questions about your own specific goals, please speak with your physician.

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Cary, North Carolina: With the recent controversy over artificial sweeteners with Aspartame, What is the American Diabetes Association's position withpeople that have Type II diabetes?

Lorena and Margie: Please see the following link to the ADA website describing the use of sweeteners: http://www.diabetes.org/nutrition-and-recipes/nutrition/sweeteners.jsp. Per the site, The American Diabetes Association accepts the FDA's conclusion that these sweeteners are safe and can be part of a healthy diet.

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vivian, louisiana: Does a sweet taste in your mouth indicate you might have diabetes?

Lorena and Margie: Although this could be due to other conditions, "Fruity" breath is one symptom of diabetic ketoacidosis, a very serious medical condition that can be the result of blood sugar that is too high. We cannot diagnose your condition. You should make an appointment to see your physician.

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bayshore, new york: when checking your blood after your meal do check two from the start of your meal or two hours from when you completed your meal???

Lorena and Margie: An ADA consensus statement published in 2001 states that a measure taken 2 hours after the start of a meal is reasonable. Please speak with your diabetes educator or physician to determine when they would prefer that you test.

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magnolia,texas: i am addicted to water, yet no matter how much i drink i am still thirsty. i drink at least two gallons per day. is this a symptom of diabetes?

Lorena and Margie: Excessive thirst is one symptom of diabetes. Another disease, Diabetes Insipidus, where there is excessive urination and excessive thirst is a condition caused by decreased action of the hormone vasopressin (as a result of pituitary gland dysfunction), or the kidney's inability to respond to antidiuretic hormone and should not be confused with Diabetes Mellitus, which results from insulin deficiency or resistance. We recommend that you make an appointment to speak with your doctor.

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Covina ,Ca: Our Clinical Lab would like the ADA recommendation for normal ranges for HGA1C.

Lorena and Margie: The ADA refers to a nondiabetic A1C as 4.0-6.0%.

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CERES CA: CAN DIABETES BE TRASMITED BY A USED NEEDLE??

Lorena and Margie: No, it cannot be transmitted from one person to another, however other diseases (such as infectious diseases) can be transmitted this way. It is important to never re-use or share an insulin syringe or lancet.

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Colorado Springs, CO: I recently took a non-fasting blood test for diabetes and the results came back as 6.3. What does that mean 6.3?

Lorena and Margie: You may be thinking of the A1C test, a test that represents your blood sugar control over the past 2-3 months. The ADA does not recommend the use of the A1C to diagnose diabetes. If you currently have diabetes, the ADA recommends a goal A1C of less than 7%. The ADA recommends a fasting (8 hours with no calorie intake) goal of 90-130 mg/dL. You should speak with your doctor to determine exactly what the test was and what your individual goal should be.

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Hutchinson, MN: Will drinking a couple of cups of coffee with non dairy creamer prior to testing blood cause glucose level to spike?

Lorena and Margie: The caffeine in coffee may cause an increase in your blood glucose levels. Typically the non-dairy creamers contain fat and sugar. This will add calories to your drink and therefore may increase your blood glucose levels also. Check the label on your non-dairy creamer to account for those calories.

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ADA Moderator : Januvia (sitagliptin) was approved by the FDA, October 16, 2006 as a prescription medicine used along with diet and exercise to lower blood sugar in patients with type 2 diabetes mellitus (type 2 diabetes). Januvia is taken once a day and may be taken alone or along with certain other medicines to control blood sugar. Januvia lowers blood sugar when blood sugar is high, especially after and between meals. In addition, it decreases the amount of sugar made by the liver and is unlikely to cause your blood sugar to be lowered to a dangerous level (hypoglycemia) because it does not work when your blood sugar is low. To learn more about this drug you can ask your physician or local pharmacist, visit www.januvia.com or contact Merck at 1-800-672?6372.

That's it for today. Thanks so much for taking the time to be here Lorena and Margie.

Thanks to all of you who joined us by asking great questions or by just tuning in. If you wish to continue any of today's discussions please feel free to visit the ADA Message Boards.

Keep up to date with all the ADA Live events and reference the archives here.

We hope you found this interesting and informative and that you'll join us again next time here at ADA Live. Our guests will be Rite Aid Pharmacists and Diabetes Care specialists at 1:00 p.m. ET Thursday, June 7, 2007. See you then.